Individual
KHOLOUD K WISHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
29160 CENTER RIDGE RD, SUITE A, WESTLAKE, OH 44145-5225
(440) 835-1899
(440) 835-1855
Mailing address
29160 CENTER RIDGE RD, SUITE A, WESTLAKE, OH 44145-5225
(440) 835-1899
(440) 835-1855
Taxonomy
Speciality
Code
Description
License number
State
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
35-076434
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000319445
ANTHEM
OH
05
—
2468664
—
OH
Enumeration date
07/19/2006
Last updated
11/21/2013
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